Treating Affect Phobia

This hands-on manual from Leigh McCullough and associates teaches the nuts and bolts of practicing short-term dynamic psychotherapy, the research-supported model first presented in Changing Character, McCullough's foundational text. Reflecting the ongoing evolution of the approach, the manual emphasizes "affect phobia," or conflict about feelings. It shows how such proven behavioral techniques as systemic desensitization can be applied effectively within a psychodynamic framework, and offers clear guidelines for when and how to intervene. Demonstrated are procedures for assessing patients, formulating core conflicts, and restructuring defenses, affects, and relationship to the self and others. Featuring a wealth of case examples, the book also includes many write-in exercises to help therapists build and practice key skills. It is an invaluable clinical resource and an ideal tool for teaching and training.

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This work is an extraordinary synthesis of depth and practicality. It is as clear, concrete, and richly exampled a treatment manual as I have seen, yet it depicts not a simple or mechanistic therapy but one that goes to the very heart of human feeling and experience. Incorporating a profoundly integrative vision, Treating Affect Phobia will be of great value not only to psychodynamically oriented therapists but to anyone in the field who appreciates the accumulating evidence for the central role of affect - and fear of affect - in our lives. - Paul L. Wachtel, PhD, Doctoral Program in Clinical Psychology, City College and the CUNY Graduate Center, New York

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Part I: Theory, Evaluation, and Formulation. Affect and Affect Phobia in Short-Term Treatment. Affect Phobia, Psychodynamic Conflict, and Malan's Two Triangles. Assessment and Selection of Treatment for the Patient. How to Formulate a Core Psychodynamic Conflict: Spotting Affect Phobias. Part II: Defense and Affect Restructuring. Introduction to Part II. Defense Restructuring Phase I: Defense Recognition. Defense Restructuring Phase II: Defense Relinquishing. Affect Restructuring Phase I: Affect Experiencing. Affect Restructuring Phase II: Affect Expression. Part III: Self- and Other- Restructuring. Introduction to Part III: Self-restructuring: Building Compassion and Care for Self. Other-restructuring: Building Adaptive Inner Images of Others. Part IV: Diagnostic Considerations and Termination. Treating Specific Diagnoses: The Relationship between DSM Diagnoses and Affect Phobias. Termination. Appendix: Answers to Exercises.

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